Individual
ERIKA RENEA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12005 TEAKWOOD CT, BRISTOL, VA 24202-3531
(276) 698-4305
Mailing address
12005 TEAKWOOD CT, BRISTOL, VA 24202-3531
(276) 698-4305
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA0000003342
TN
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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